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Graham GD, Jeray KJ. Posttraumatic Patellar Osteomyelitis due to Raoultella ornithinolytica: A Case Report. JBJS Case Connect 2023; 13:01709767-202303000-00039. [PMID: 36795860 DOI: 10.2106/jbjs.cc.22.00590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
CASE A 59-year-old woman sustained a comminuted patellar fracture after a fall from standing. The injury was treated with open reduction and internal fixation 7 days from initial injury. Seven weeks postoperatively, she developed a swollen, painful, and draining knee. Workup demonstrated Raoultella ornithinolytica. She underwent surgical debridement and antibiotic treatment. CONCLUSION This is an unusual presentation of patellar osteomyelitis with R. ornithinolytica. Early identification, treatment with appropriate antimicrobial therapy, and consideration of surgical debridement are important in patients presenting with pain, swelling, and erythema after surgery.
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Affiliation(s)
- George D Graham
- Department of Orthopaedic Surgery, Prisma Health - Upstate, Greenville, South Carolina
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Abd El-Ghany WA. A spotlight on Raoultella ornithinolytica: A newly emerging life-threatening zoonotic pathogen. INTERNATIONAL JOURNAL OF ONE HEALTH 2021. [DOI: 10.14202/ijoh.2021.1-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The genus Raoultella contains Raoultella ornithinolytica (R. ornithinolytica), which was previously named as Klebsiella ornithinolytica. R. ornithinolytica is a Gram-negative bacillus that belongs to the family Enterobacteriaceae. This pathogen is normally present in aquaculture, and it has been isolated from fish, insects, and wild and domestic birds. Seafood and poultry products are incriminated as sources of R. ornithinolytica infection. Community-acquired human infection with R. ornithinolytica is common. This infection is commonly associated with sepsis, bacteremia, food poisoning, purities, and urinary and respiratory tracts' infections. Rapid acquired resistance of R. ornithinolytica strains is common, and it is related to the development of resistant genes. R. ornithinolytica is considered as a newly emerging life-threatening pathogen world-wide. Hence, it is very important to determine the role of animals and birds in the epidemiological situation of this pathogen as well as the detection of antibiotic resistance genes before treatment.
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Affiliation(s)
- Wafaa A. Abd El-Ghany
- Department of Poultry Diseases, Faculty of Veterinary Medicine, Cairo University, Egypt
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Yu C, Wei X, Wang Z, Liu L, Liu Z, Liu J, Wu L, Guo H, Jin Z. Occurrence of two NDM-1-producing Raoultella ornithinolytica and Enterobacter cloacae in a single patient in China: probable a novel antimicrobial resistance plasmid transfer in vivo by conjugation. J Glob Antimicrob Resist 2020; 22:835-841. [PMID: 32652247 DOI: 10.1016/j.jgar.2020.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/06/2020] [Accepted: 06/18/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To identify the general features of acquisition of drug-resistance genes in two multi-drug resistant Enterobacteriaceae strains isolated from a single patient in China. METHODS The whole-plasmid was sequenced by Illumina Hiseq 4000 and Pacbio RSII procedures. The plasmid conjugation transfer experiment were performed by the mating-out assay. Drug-resistance genes were amplified by PCR assay. RESULTS We identified two New Delhi metallo-β-lactamase type 1(NDM-1)-producing isolates, named Raoultella ornithinolytica B1645-1 and Enterobacter cloacae B1645-2, which shared the same sulfonamide-resistant dihydropteroate synthase sul2 gene and aminoglycoside O-phosphotransferase aph(3'')-Ib gene. A novel antimicrobial resistance plasmid pCYNDM01 was first discovered from the multi-drug resistant R. ornithinolytica B1645-1. Interestingly, plasmid pCYNDM01 carried a Gifsy-2 prophage gene. The blaNDM-1 gene was located on a novel complex class 1 integron with a structure of sul1-qacEΔ1-ΔISAba125-blaNDM-1-blaMBL-trpC-ISCR1-catb8-aacA4-IS1-IS6100-dfrA14-intI1. The carrying the blaNDM-1 gene plasmid pCYNDM01 was transferred to the E. cloacae B1645-2 recipient strain. This 149.44 kb plasmid pCYNDM01 belonged to the IncFII type. CONCLUSIONS A novel antimicrobial resistance plasmid pCYNDM01 was first recovered from a multi-drug resistance R. ornithinolytica B1645-1 isolated from China. The novel complex sul1-type class 1 integron might play an essential role in the mobilization of the blaNDM-1 gene among different enterobacterial species. The occurrence of plasmid pCYNDM01 transfer from R. ornithinolytica to E. cloacae in vitro by conjugation showed that plasmid pCYNDM01 was a self-conjugative plasmid and might cause dissemination of drug-resistance genes within different enterobacterial species from a single patient in vivo by conjugation. The novel variant F-like T4SS of plasmid pCYNDM01 might be as a tool of R. ornithinolytica B1645-1 for resistance genes transfer. The emergence of the two NDM-1-producing Enterobacteriaceae strains should be attracted China attentions and required to prevent its future prevalence.
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Affiliation(s)
- Chunfang Yu
- Department of Microbiology, School of Basic Medical Sciences, Hubei University of Medicine, Hubei, Shiyan 442000, China; Department of Clinical Laboratory, Affiliated dongfeng Hospital, Hubei University of Medicine, Hubei, Shiyan 442000, China; Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei, Shiyan 442000, China
| | - Xiuli Wei
- Department of Microbiology, School of Basic Medical Sciences, Hubei University of Medicine, Hubei, Shiyan 442000, China
| | - Zuhua Wang
- Department of Blood Transfusion, Taihe Hospital, Hubei, Shiyan 442008, China
| | - Long Liu
- Department of Microbiology, School of Basic Medical Sciences, Hubei University of Medicine, Hubei, Shiyan 442000, China
| | - Zhixin Liu
- Department of Microbiology, School of Basic Medical Sciences, Hubei University of Medicine, Hubei, Shiyan 442000, China
| | - Ji Liu
- First College of Clinical Medicine, Institute of Medicine and Nursing, Hubei University of Medicine, Hubei, Shiyan 442000, China
| | - Lingling Wu
- School of Basic Medical Science, Hubei University of Medicine, Hubei, Shiyan 442000, China
| | - Huailan Guo
- School of Public Health and Management, Hubei University of Medicine, Hubei, Shiyan 442000, China; Center for Environment and Health in Water Source Area of South-to-North Water Diversion, Hubei University of Medicine, Hubei, Shiyan 442000, China
| | - Zhixiong Jin
- Department of Clinical Laboratory, Affiliated dongfeng Hospital, Hubei University of Medicine, Hubei, Shiyan 442000, China.
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Hajjar R, Ambaraghassi G, Sebajang H, Schwenter F, Su SH. Raoultella ornithinolytica: Emergence and Resistance. Infect Drug Resist 2020; 13:1091-1104. [PMID: 32346300 PMCID: PMC7167274 DOI: 10.2147/idr.s191387] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/13/2019] [Indexed: 11/23/2022] Open
Abstract
Raoultella ornithinolytica is an encapsulated Gram-negative, oxidase-negative, catalase-positive, aerobic, non-motile rod that belongs to the Enterobacteriaceae family. This bacterium was initially classified in the genus Klebsiella as Klebsiella ornithinolytica, until the creation of the genus Raoultella in 2001. R. ornithinolytica is usually found in water environments and soil, and due to its ability to convert histidine to histamine, it has been associated with histamine poisoning in humans. R. ornithinolytica is an emerging entity in human infections, with several reports of virulent infections in comorbid at-risk patients. Increasing reports are potentially due to better and more precise identification tools. The objective of this article is to provide a comprehensive review of reported cases of R. ornithinolytica infections, the emergent virulence of described multiresistant strains, and an overview of currently used identification methods.
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Affiliation(s)
- Roy Hajjar
- Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Georges Ambaraghassi
- Department of Medical Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Herawaty Sebajang
- Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Frank Schwenter
- Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Shih-Hann Su
- Department of Medical Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
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Hammad DBM, Liyanapathirana V, Tonge DP. Molecular characterisation of the synovial fluid microbiome in rheumatoid arthritis patients and healthy control subjects. PLoS One 2019; 14:e0225110. [PMID: 31751379 PMCID: PMC6871869 DOI: 10.1371/journal.pone.0225110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/28/2019] [Indexed: 12/13/2022] Open
Abstract
METHODS The presence and identity of bacterial and fungal DNA in the synovial fluid of rheumatoid arthritis (RA) patients and healthy control subjects was investigated through amplification and sequencing of the bacterial 16S rRNA gene and fungal internal transcribed spacer region 2 respectively. Synovial fluid concentrations of the cytokines IL-6, IL-17A, IL22 and IL-23 were determined by ELISA. RESULTS Bacterial 16S rRNA genes were detected in 87.5% RA patients, and all healthy control subjects. At the phylum level, the microbiome was predominated by Proteobacteria (Control = 83.5%, RA = 79.3%) and Firmicutes (Control = 16.1%, RA = 20.3%), and to a much lesser extent, Actinobacteria (Control = 0.2%, RA = 0.3%) and Bacteroidetes (Control = 0.1%, RA = 0.1%). Fungal DNA was identified in 75% RA samples, and 88.8% healthy controls. At the phylum level, synovial fluid was predominated by members of the Basidiomycota (Control = 53.9%, RA = 46.9%) and Ascomycota (Control = 35.1%, RA = 50.8%) phyla. Statistical analysis revealed key taxa that were differentially present or abundant dependent on disease status. CONCLUSIONS This study reports the presence of a synovial fluid microbiome, and determines that this is modulated by disease status (RA) as are other classical microbiome niches.
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Affiliation(s)
- Dargham Bayan Mohsen Hammad
- School of Life Sciences, Faculty of Natural Sciences, Keele University, Keele, Newcastle, England, United Kingdom
| | | | - Daniel Paul Tonge
- School of Life Sciences, Faculty of Natural Sciences, Keele University, Keele, Newcastle, England, United Kingdom
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Ayoade F, Mada PK, Alam M. Fat necrosis and polymicrobial wound infection caused partly by Raoultella ornithinolytica after reduction mammoplasty. BMJ Case Rep 2018; 2018:bcr-2018-224234. [PMID: 29866679 DOI: 10.1136/bcr-2018-224234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Raoultella ornithinolytica is a rare opportunistic aerobic gram-negative bacillus that naturally exists in soil, water and plants. The pathogen has been described in association with diabetic foot infections, biliary infections, bacteraemia and native and prosthetic joint infections. Fat necrosis and wound infection following breast reduction surgery or other plastic surgeries caused by this pathogen have not been previously described. We present a case of bilateral fat necrosis, wound infection and dehiscence in a 24-year-old woman with no significant past medical problems. She initially had an uneventful early postoperative course but 3 weeks after surgery noticed pain and discharge from both nipple/areola area of both breasts which later developed into full-thickness fat necrosis and complete destruction of the nipple areolar complex. R. ornithinolytica, Escherichia coli and Enterococcus faecalis were identified from wound exudate cultures. She was treated with surgical debridement and 2 weeks of appropriate antibiotics with a favourable outcome.
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Affiliation(s)
- Folusakin Ayoade
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Pradeep Kumar Mada
- Division of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
| | - Mohammad Alam
- Division of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
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Marietto-Gonçalves GA, Lima EL, Nagayoshi BA, Tonin AA, Knöbl T, Adreatti Filho RL. Raoultella ornithinolytica Isolation in Cloacal Microbiota of Tinamus solitarius: Preliminary Data. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2018. [DOI: 10.1590/1806-9061-2017-0599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | | | | | - AA Tonin
- Instituto Federal de Ciências e Tecnologia do Amazonas, Brazil
| | - T Knöbl
- Universidade de São Paulo, Brazil
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Bonnet E, Julia F, Giordano G, Lourtet-Hascoet J. Joint infection due to Raoultella planticola: first report. Infection 2017; 45:703-704. [PMID: 28337666 DOI: 10.1007/s15010-017-1006-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/08/2017] [Indexed: 11/24/2022]
Abstract
The genus Raoultella has been separated from the genus Klebsiella in 2001. Two main species are responsible for human infections: R. ornithinolytica and R. planticola. The most frequent infections due to R. planticola include cystitis, pneumonia and bacteremia (mostly in immunocompromised hosts). To date, no joint or bone infection has been reported. We describe the first case of septic arthritis due to R. planticola following an arthroscopy with intra-articular injection of corticosteroids. Evolution was favorable after arthroscopic lavage and antibiotic therapy with quinolones. Raoultella planticola has been described rarely in human infection. It is mainly deemed responsible for cystitis, pneumonia and bacteremia (mostly in immunocompromised hosts) [1-3]. To our knowledge no case of bone or joint infection has been reported. We described here the first case of infective arthritis due to R. planticola involving a native knee joint following synovectomy and intra-articular injection of corticosteroids during arthroscopy.
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Affiliation(s)
- E Bonnet
- Hôpital Joseph Ducuing, Toulouse, France.
| | - F Julia
- Clinique Toulouse Lautrec, Albi, France
| | - G Giordano
- Hôpital Joseph Ducuing, Toulouse, France
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